Factorial validity and gender invariance of the Patient Health Questionnaire (PHQ-9) in student-athletes

Abstract

Background/purpose

Depressive symptoms are prevalent in student-athletes. Evidence for the factorial validity of measures assessing depressive symptoms in student-athletes is presently absent from the literature. This study examined the best fitting factorial structure and invariance across sexes of the PHQ-9.

Methods

Data were collected from 1,524 student-athletes from institutions in the North-Eastern United States. Confirmatory factor analyses of 4 factorial structures of the Patient Health Questionnaire-9 (PHQ-9) were conducted, followed by invariance analyses across sexes.

Results

All tested models showed an excellent fit for all tested models and a unidimensional model of the PHQ-9 was chosen for further analyses. Metric and scalar invariance for the identified model across sexes was supported. The participants in this study reported an unusually low (3.13%) prevalence of elevated depressive symptoms, which may indicate underreporting of symptoms.

Conclusion

Using a unidimensional, composite score via the PHQ-9 is a valid assessment of depressive symptoms in male and female student-athletes.

Keywords:

• Depression
• PHQ-9
• mental health
• student-athletes

Conflict of interest disclosure

The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States and received approval from the IRB at Temple University, West Chester University, and Ithaca College.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.